Yoshida Yu, Shingu Takayuki, Harada Yuuki, Ida Sumire, Takubo Kazuko
Division of Oral Surgery, Matsue Red Cross Hospital, Matsue 690-8506, Japan.
Division of Oral Surgery, National Hospital Organization Yonago Medical Center, Yonago 683-0006, Japan.
Yonago Acta Med. 2023 Apr 26;66(2):292-296. doi: 10.33160/yam.2023.05.005. eCollection 2023 May.
Garré's osteomyelitis, first described by Carl Garré in 1893, is a type of chronic osteomyelitis accompanied by hyperplastic periostitis. This condition affects relatively young patients and occurs in the fibula, femur, and other long bones as chronic non-purulent sclerosing osteomyelitis. Further, reactive periosteal bone formation develops due to chronic irritation or infection. In the maxillofacial region, it often occurs in the first molar region of the mandible due to caries and other similar causes, and it is rarely associated with impacted teeth. Herein, we present a 12-year-old female patient who primarily complained of swelling on the right side of the mandible. Despite taking antibiotics prescribed at local otolaryngologist, the swelling did not completely resolve. Thus, the patient was referred to the Department of Otorhinolaryngology at our hospital, where a dental-related disease was suspected. On a computed tomography scan, radiolucent findings were observed around the germ of the impacted wisdom tooth as well as hyperostosis in the lower jaw. Thus, Garré's osteomyelitis was suspected. The patient received oral anti-inflammatory treatment by the incision prior to surgery. Thereafter, the tooth germ was enucleated and newly-formed bone, which was laterally located to the cortical bone of the mandible, was removed under the effect of general anesthesia. On computed tomography scan 9 months after the surgery, hyperostosis in the angle of the mandible disappeared. Thereafter, pain and swelling did not recur, and the patient was doing well.
加雷骨髓炎由卡尔·加雷于1893年首次描述,是一种伴有增生性骨膜炎的慢性骨髓炎。这种疾病影响相对年轻的患者,表现为腓骨、股骨和其他长骨的慢性非化脓性硬化性骨髓炎。此外,由于慢性刺激或感染会形成反应性骨膜骨。在颌面部区域,它常因龋齿和其他类似原因发生在下颌第一磨牙区,很少与阻生牙有关。在此,我们报告一名12岁女性患者,主要主诉下颌右侧肿胀。尽管服用了当地耳鼻喉科医生开的抗生素,但肿胀并未完全消退。因此,患者被转诊至我院耳鼻喉科,怀疑是与牙齿相关的疾病。在计算机断层扫描中,在阻生智齿牙胚周围观察到透射性表现以及下颌骨骨质增生。因此,怀疑为加雷骨髓炎。患者在手术前通过切口接受了口服抗炎治疗。此后,在全身麻醉下摘除牙胚并切除位于下颌骨皮质骨外侧的新形成骨。手术后9个月的计算机断层扫描显示,下颌角骨质增生消失。此后,疼痛和肿胀未再复发,患者情况良好。